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Opioids Oxycodone hit or miss. What's going on?

Automator

Automator

Bluelighter
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Mar 5, 2019
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In pain management, my doctor has me on 3 x 20's of IR oxycodone daily. Sometimes they work really well in managing my pain. Other times, the pain feels "worse" and I feel like crap. Same dose daily, same time, same pills. Not taking more than prescribed.

I was on oxy ER 10 years ago, they kept the pain at bay while boosting my mood, decreasing my anxiety.

Should I try ER again?

I just find it strange that it'll work one day, then I feel like garbage the next.

If anymore info is needed, lmk. Thanks in advance.
 
Automator said:
In pain management, my doctor has me on 3 x 20's of IR oxycodone daily. Sometimes they work really well in managing my pain. Other times, the pain feels "worse" and I feel like crap. Same dose daily, same time, same pills. Not taking more than prescribed.

I was on oxy ER 10 years ago, they kept the pain at bay while boosting my mood, decreasing my anxiety.

Should I try ER again?

I just find it strange that it'll work one day, then I feel like garbage the next.

If anymore info is needed, lmk. Thanks in advance.
Click to expand...
I can only speculate that due to other factors it may be affecting your levels of Oxycodone, whether that’s from it being processed quicker one day to the next due to what you’ve ate, poor sleep, etc but that could just be bro science.

It’s usual to notice a escalating tolerance and less of a effect but it’s unusual if one day is better than not, but this happens to me with my Stimulant, but I suspect it’s outside factors, small things like having Omega 3s and Magnesium noticeably positively affect the treatment for example.

I’m always a advocate of ER meds and for me IR really is crashes and peaks.

Opioids or stimulants, IR stims can be brutal but I’d say Opioids worse.

In my experience I found say IR DHC versus ER DHC are way different, both at the same tolerances and dose (240mg)

I found a minimal more positive at IR to then having a massive increase in negative.

ER is smooth as butter and mellows out nicely in time for bed.

I’ve had far more positive outcomes having a steadier level all day, especially for opioids, less is always more when treating, and I find IR is taking far more away for a tiny window of greater relief.

^ final ramble, but I speculate that a greater and shorter peak concentration of a med, then redosing will lead to worsening effects across the day versus..
a steady rising level that then hits a peak far further in, and slowly drops..
Maybe leading to less resitance from the receptors, I.e a less aggressive reaction from clearing a large amount of drug, as otherwise it’ll be more prepared when that next IR hits.

Ultimately I’m just speculating bro science so do not take my word for it.
 
Last edited:
I have been on Roxicodone 30mg for going on 15 years now. Most of what you are describing is due to tolerance and dependence to the drug. It has nothing to due with the drug itself unless you are filling certain brands such as "RP" (Rhodes) -- they suck.

Mallinckrodt is the best generic option and the best brand name option. However, Mallinckrodt's 10mg & 20mg generic tablets have switched to the new "SpecGX" construction. Not sure why they did this exactly but I assume it is from a recent merger with a company to give them part of the stake or if the SpecGX does not dissolve in water and/or could be not as pleasurable to snort.

Back to the thread topic, I have days when the Roxicodone (Oxycodone HCl) seems to not work as well as others. I have found it comes from sleep, hydration, empty stomach, stress, and chemical imbalance or immune system dip. I started dissolving them under my tongue earlier this year and it started to work much much better for me.

Roxicodone/Oxycodone HCl is not as sedating as morphine, Hydromorphone. Some people think this is why it is not working as well. No... the Oxycodone is still working just fine. It is just your tolerance or the other facts I mentioned. With this being said, Oxycodone's consistent strength is better than morphine or Hydromorphone and the bioavailability of Oxycodone has a lot to do with that. I would suggest dissolving them under your tongue if you have any Mallinckrodt (M-30) or KV-Tech (K-9) brands.

My doctor put me on Methadone IR 10mg 3-4 times per day to keep the Oxycodone from dipping below the baseline I require and for more pain relief, better nights sleep without waking from withdrawals, and dependence. The Methadone really makes a huge difference. They are the Mallinckrodt brand and they only brand I will take.

Something else if Clonidine IR taken with the Oxycodone increases pain relief, sedation, and overall effect of the opioid. Or adding a small dose of Ativan 0.5mg-1mg with the opioid.
 
KurtAurelius said:
I can only speculate that due to other factors it may be affecting your levels of Oxycodone, whether that’s from it being processed quicker one day to the next due to what you’ve ate, poor sleep, etc but that could just be bro science.

It’s usual to notice a escalating tolerance and less of a effect but it’s unusual if one day is better than not, but this happens to me with my Stimulant, but I suspect it’s outside factors, small things like having Omega 3s and Magnesium noticeably positively affect the treatment for example.

I’m always a advocate of ER meds and for me IR really is crashes and peaks.

Opioids or stimulants, IR stims can be brutal but I’d say Opioids worse.

In my experience I found say IR DHC versus ER DHC are way different, both at the same tolerances and dose (240mg)

I found a minimal more positive at IR to then having a massive increase in negative.

ER is smooth as butter and mellows out nicely in time for bed.

I’ve had far more positive outcomes having a steadier level all day, especially for opioids, less is always more when treating, and I find IR is taking far more away for a tiny window of greater relief.

^ final ramble, but I speculate that a greater and shorter peak concentration of a med, then redosing will lead to worsening effects across the day versus..
a steady rising level that then hits a peak far further in, and slowly drops..
Maybe leading to less resitance from the receptors, I.e a less aggressive reaction from clearing a large amount of drug, as otherwise it’ll be more prepared when that next IR hits.

Ultimately I’m just speculating bro science so do not take my word for it.
Click to expand...
does er hit as hard as ir? I used to LOVE Oxy. Like LOVE it, but I don't like when the ir hits most of the time.
 
Them Witches said:
I have been on Roxicodone 30mg for going on 15 years now. Most of what you are describing is due to tolerance and dependence to the drug. It has nothing to due with the drug itself unless you are filling certain brands such as "RP" (Rhodes) -- they suck.

Mallinckrodt is the best generic option and the best brand name option. However, Mallinckrodt's 10mg & 20mg generic tablets have switched to the new "SpecGX" construction. Not sure why they did this exactly but I assume it is from a recent merger with a company to give them part of the stake or if the SpecGX does not dissolve in water and/or could be not as pleasurable to snort.

Back to the thread topic, I have days when the Roxicodone (Oxycodone HCl) seems to not work as well as others. I have found it comes from sleep, hydration, empty stomach, stress, and chemical imbalance or immune system dip. I started dissolving them under my tongue earlier this year and it started to work much much better for me.

Roxicodone/Oxycodone HCl is not as sedating as morphine, Hydromorphone. Some people think this is why it is not working as well. No... the Oxycodone is still working just fine. It is just your tolerance or the other facts I mentioned. With this being said, Oxycodone's consistent strength is better than morphine or Hydromorphone and the bioavailability of Oxycodone has a lot to do with that. I would suggest dissolving them under your tongue if you have any Mallinckrodt (M-30) or KV-Tech (K-9) brands.

My doctor put me on Methadone IR 10mg 3-4 times per day to keep the Oxycodone from dipping below the baseline I require and for more pain relief, better nights sleep without waking from withdrawals, and dependence. The Methadone really makes a huge difference. They are the Mallinckrodt brand and they only brand I will take.

Something else if Clonidine IR taken with the Oxycodone increases pain relief, sedation, and overall effect of the opioid. Or adding a small dose of Ativan 0.5mg-1mg with the opioid.
Click to expand...
Tried the sublingual administration today. That's a no no for me. Definitely hit like a ton of bricks and freaked me out thinking I overdid it. Old me would have found it incredibly enjoyable. I don't know why my body doesn't tolerate opiates anymore. I NEED them though. My life sucks, lol.
 
Automator said:
Tried the sublingual administration today. That's a no no for me. Definitely hit like a ton of bricks and freaked me out thinking I overdid it. Old me would have found it incredibly enjoyable. I don't know why my body doesn't tolerate opiates anymore. I NEED them though. My life sucks, lol.
Click to expand...
Oh shit... Sorry for suggesting that. I keep forgetting not everyone has the tolerance I have. But at least you know if you are in intense pain there is a way to deal with it.

I mentioned this on the forums earlier this year and a few people thought I was crazy that it worked so well and lasted much longer.

I hope you are alright. And yeah..My life is not very fun either.
 
Them Witches said:
Oh shit... Sorry for suggesting that. I keep forgetting not everyone has the tolerance I have. But at least you know if you are in intense pain there is a way to deal with it.

I mentioned this on the forums earlier this year and a few people thought I was crazy that it worked so well and lasted much longer.

I hope you are alright. And yeah..My life is not very fun either.
Click to expand...
All good man. I can break one in half and sublingual 15mg. Bet that helps.
 
Automator said:
All good man. I can break one in half and sublingual 15mg. Bet that helps.
Click to expand...
I have been on the Roxi 30's going on 15 years. Dissolving them under the tongue also makes them last longer for me. Pain relief is better and it extends the time frame to when my brain wants another dose.

Roxicodone (Oxycodone HCl) and Methadone are the only two pain killers that keep working after multiple decades. Morphine, Diluadid, and Oxymorphone started to not work so good mostly due to the PO (oral) bioavailability.
 
Them Witches said:
I have been on Roxicodone 30mg for going on 15 years now. Most of what you are describing is due to tolerance and dependence to the drug. It has nothing to due with the drug itself unless you are filling certain brands such as "RP" (Rhodes) -- they suck.

Mallinckrodt is the best generic option and the best brand name option. However, Mallinckrodt's 10mg & 20mg generic tablets have switched to the new "SpecGX" construction. Not sure why they did this exactly but I assume it is from a recent merger with a company to give them part of the stake or if the SpecGX does not dissolve in water and/or could be not as pleasurable to snort.

Back to the thread topic, I have days when the Roxicodone (Oxycodone HCl) seems to not work as well as others. I have found it comes from sleep, hydration, empty stomach, stress, and chemical imbalance or immune system dip. I started dissolving them under my tongue earlier this year and it started to work much much better for me.

Roxicodone/Oxycodone HCl is not as sedating as morphine, Hydromorphone. Some people think this is why it is not working as well. No... the Oxycodone is still working just fine. It is just your tolerance or the other facts I mentioned. With this being said, Oxycodone's consistent strength is better than morphine or Hydromorphone and the bioavailability of Oxycodone has a lot to do with that. I would suggest dissolving them under your tongue if you have any Mallinckrodt (M-30) or KV-Tech (K-9) brands.

My doctor put me on Methadone IR 10mg 3-4 times per day to keep the Oxycodone from dipping below the baseline I require and for more pain relief, better nights sleep without waking from withdrawals, and dependence. The Methadone really makes a huge difference. They are the Mallinckrodt brand and they only brand I will take.

Something else if Clonidine IR taken with the Oxycodone increases pain relief, sedation, and overall effect of the opioid. Or adding a small dose of Ativan 0.5mg-1mg with the opioid.
Click to expand...
Are the KVK tech 15s any good? I got switched to those from the Mali 5’s and was curious. I just told the pharmacy I didn’t want the specgx (both the 10s and 20s suck even orally)
 
Automator said:
In pain management, my doctor has me on 3 x 20's of IR oxycodone daily. Sometimes they work really well in managing my pain. Other times, the pain feels "worse" and I feel like crap. Same dose daily, same time, same pills. Not taking more than prescribed.

I was on oxy ER 10 years ago, they kept the pain at bay while boosting my mood, decreasing my anxiety.

Should I try ER again?

I just find it strange that it'll work one day, then I feel like garbage the next.

If anymore info is needed, lmk. Thanks in advance.
Click to expand...
The best pain management pill I’ve ever taken is Oxymorphone ER. I take that along with 15mg oxy IR and that’s been the best combo of anything I ever had
 
Which brand oxymorph er did you get? The Activas could be easily crushed and snorted. I used to get the 15mg er activas.. that half moon symbol on the white tablet summed up the punch the 15mgs had.
 
thegardensallnighterz said:
Which brand oxymorph er did you get? The Activas could be easily crushed and snorted. I used to get the 15mg er activas.. that half moon symbol on the white tablet summed up the punch the 15mgs had.
Click to expand...
Amneal I get little pink 5s. Can’t easily take coating off and crush em. Are the KVK 15s (Oxycodone) good?
 
jgoz7 said:
Are the KVK tech 15s any good? I got switched to those from the Mali 5’s and was curious. I just told the pharmacy I didn’t want the specgx (both the 10s and 20s suck even orally)
Click to expand...
The KVK teck are good for dissolve. Mallinckrodt is always the best for under the tongue.

I do not think the KVK tech are any better, just cost more. The hospitals use KVK oxycodone more in some states.

Mallinckrodt generic trump. They cost less than a penny for 30mg. $0.006 exactly with insurance.

Out-of pocket for KVK and Mallin are almost the same for 180qty 30mg. $86 vs $73 at a pharmacy.

Mallinckrodt changed their 20mg and 10mg IR to SpecGX. still dissolves good, not as good as the 30mg and 15mg versions
 
Them Witches said:
The KVK teck are good for dissolve. Mallinckrodt is always the best for under the tongue.

I do not think the KVK tech are any better, just cost more. The hospitals use KVK oxycodone more in some states.

Mallinckrodt generic trump. They cost less than a penny for 30mg. $0.006 exactly with insurance.

Out-of pocket for KVK and Mallin are almost the same for 180qty 30mg. $86 vs $73 at a pharmacy.

Mallinckrodt changed their 20mg and 10mg IR to SpecGX. still dissolves good, not as good as the 30mg and 15mg versions
Click to expand...
Yeah I’ve tried both the 10 and 20mg specgx I hated them. The maili 5s though worked great. If you had to pick between 15mg kvk or mailinkroftd what would be your choice ?
 
jgoz7 said:
Yeah I’ve tried both the 10 and 20mg specgx I hated them. The maili 5s though worked great. If you had to pick between 15mg kvk or mailinkroftd what would be your choice ?
Click to expand...
Mallinckrodt 15mg is my 1st choice. KVK-Tech 15mg comes in a close 2nd choice.

Some months I end up with both brands to complete the Rx.

I think that KVK-Tech's delivery is slower and lacks sublingual effect.

Tums helps keep the Oxy in the liver longer
steroids help it cross the BBB better
cimetidine increases blood plasma levels of oxy
 
Last edited:
I have bouts, like now, when the pain pills hit incredibly hard. Same dose. Same time. Same everything. I don't understand what my body is doing.

Does the mind and body have to be stress free for them to work correctly?

I just feel weird. But a lot has happened in my life recently to increase anxiety and stress.

Can my SSRI have a say in this debacle?
 
Equianalgesic ratio of oxymorphone (79.4 mg) to oxycodone (155 mg) was 1:2 in a intense medical trial up to 440mg of Oxymorphone daily. They always issue placebos randomly but the patient gets 2 rescue doses per day. I would throw my ice cream or yogurt at the wall if I got a placebo. They'd stop bring them.
 
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